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Use of capnography to verify emergency ventilator sharing in the COVID-19 era
Respiratory Physiology & Neurobiology ( IF 2.3 ) Pub Date : 2020-12-24 , DOI: 10.1016/j.resp.2020.103611
Anita Korsós 1 , Ferenc Peták 2 , Roberta Südy 1 , Álmos Schranc 2 , Gergely H Fodor 2 , Barna Babik 1
Affiliation  

Exacerbation of COVID-19 pandemic may lead to acute shortage of ventilators, which may require shared use of ventilator as a lifesaving concept. Two model lungs were ventilated with one ventilator to i) test the adequacy of individual tidal volumes via capnography, ii) assess cross-breathing between lungs, and iii) offer a simulation-based algorithm for ensuring equal tidal volumes. Ventilation asymmetry was induced by placing rubber band around one model lung, and the uneven distribution of tidal volumes (VT) was counterbalanced by elevating airflow resistance (HR) contralaterally. VT, end-tidal CO2 concentration (ETCO2), and peak inspiratory pressure (Ppi) were measured. Unilateral LC reduced VT and elevated ETCO2 on the affected side. Under HR, VT and ETCO2 were re-equilibrated. In conclusion, capnography serves as simple, bedside method for controlling the adequacy of split ventilation in each patient. No collateral gas flow was observed between the two lungs with different time constants. Ventilator sharing may play a role in emergency situations.



中文翻译:

使用二氧化碳图验证 COVID-19 时代的紧急呼吸机共享

COVID-19 大流行的加剧可能会导致呼吸机严重短缺,这可能需要共享呼吸机作为救生概念。使用一台呼吸机对两个模型肺进行通气,i) 通过二氧化碳图测试各个潮气量的充足性,ii) 评估肺部之间的交叉呼吸,以及 iii) 提供基于模拟的算法以确保潮气量相等。通过在模型肺周围放置橡皮筋来诱导通气不对称,并通过提高对侧气流阻力(HR)来平衡潮气量(VT)的不均匀分布。测量VT、呼气末CO 2浓度(ETCO 2 )和吸气峰值压力(Ppi)。单侧 LC 会降低患侧的VT 并升高 ETCO 2 。在 HR 下,VT 和 ETCO 2重新平衡。总之,二氧化碳图是一种简单的床旁方法,用于控制每位患者分流通气的充分性。在具有不同时间常数的两个肺之间没有观察到侧支气流。呼吸机共享在紧急情况下可能会发挥作用。

更新日期:2020-12-29
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